We describe a 5-year-old child with hypertrophic cardiomyopathy, mitochondr
ial myopathy, and lactic acidosis. Mitochondrial DNA analysis showed a hete
roplasmic A5814G point mutation in the tRNA(Cys) gene. The mutational load
was extremely high (> 95%) in muscle, fibroblasts, and blood. This report e
xpands the clinical heterogeneity of the A5814G mutation, which should be c
onsidered in the differential diagnosis of hytertrophic cardiomyopathy in c
hildhood.